Hibuki therapy as a method of psychological support for war trauma in Ukrainian children

BackgroundThe Russian invasion of Ukraine resulted in a dramatic increase of children and adolescents being confronted with war and other traumatic experiences, which could result in an increase of trauma-related mental health disorders such as posttraumatic stress disorder (PTSD) in an entire generation. This study aims at reporting the prevalence of traumatic events, PTSD, and Complex PTSD (CPTSD) in children and adolescents seeking for mental health treatment since the Russian invasion. Additionally, the consistency of child and caregiver reported trauma, PTSD and CPTSD will be examined.MethodsThis study is part of the “TF-CBT Ukraine” project in which Ukrainian therapists were trained in assessing their patients via the “Child and Adolescent Trauma Screen” (CATS-2) before initiating trauma-focused treatment, if indicated. Altogether N = 200 Ukrainian children and adolescents (Mage = 12.01, range 4–21; 62.0% female) were included in the study between October 2022 and August 2023. Data were analysed descriptively, via t-tests and bivariate correlations.ResultsThe children and adolescents reported on average four different traumatic events, most frequently war (n = 123; 68.7%), bullying threats (n = 71; 39.7%) and domestic violence (n = 68; 38.0%). Almost 70% (n = 123) of the participants fulfilled the DSM-5 PTSD criteria, 31% (n = 56) fulfilled the ICD-11 PTSD criteria and 21% (n = 38) the ICD-11 CPTSD criteria. Rates of PTSD were even higher in preschool children (95%). The comparisons of self-and caregiver reports on traumatic events and PTSD/CPTSD severity scores indicated moderate to high correlations between the patients and their caregivers (r = 0.710–0.767).ConclusionsThis study shows that Ukrainian children and adolescents starting treatment report a high number of traumatic events and trauma-related symptoms, which could have a long-lasting negative impact on their social-emotional development and quality of life. The implementation of evidence-based trauma-focused interventions for these children is therefore crucial.

The purpose of this article is to present and test an adaptation of the Child and Adolescent Trauma Screen (CATS) methodology for the Ukrainian-speaking population affected by the war in Ukraine. The study focuses on developing a reliable instrument to assess trauma-induced psychopathology among children and adolescents, taking into account the unique cultural and contextual characteristics of the target population. Research methods. The study uses a combination of theoretical analysis and psychometric evaluation methods to test the reliability and validity of the adapted CATS questionnaire. Statistical analysis, including internal consistency analysis, component analysis, and factor analysis, were performed using R software version 4.2.2. Results. The adapted CATS methodology demonstrates high internal consistency (α = 0.850) and has a three-factor structure that explains various aspects of the impact of trauma and related symptoms on Ukrainian children and adolescents. Confirmatory factor analysis has indicated acceptable goodness-of-fit indices, confirming the validity of the adapted CATS questionnaire in assessing trauma-related psychopathology in the target population. Conclusions. The study concludes that the adapted CATS methodology is a valid tool for identifying traumatic psychopathology in Ukrainian children and adolescents who have suffered from war. Using it provides greater understanding of the war’s impact on mental health. In addition, analysis of the methodology points to the importance of culturally sensitive screening tools in addressing the mental health crisis among war-affected populations. By providing a reliable means of identifying psychological distress, the adapted CATS questionnaire can facilitate targeted interventions to mitigate the adverse effects of trauma and enhance resilience among Ukrainian youth. Keywords: Childhood and Adolescent Trauma Screen (CATS), adaptation, psychometric assessment, traumatic psychopathology, Ukrainian-speaking population, mental health crisis

The war in Ukraine is the largest humanitarian crisis that Europe has faced in recent years, and our country, Romania, was directly involved in managing the situation created by the refuge of millions of Ukrainians (in particular, mothers and children) who left the country at the beginning of the armed conflict. This type of conflict has had a strong negative impact on children, especially Ukrainian children, and the thus generated trauma can affect the development of self-identity, of spirituality or of the world perspective due to its influence on cognitive processes involving the development of trust, intimacy, control, security, and power. Through our case study we capture the psychological effects of war on children, and the technique „ storytelling” as an effective method of intervention in treating war trauma in children.

Harmonious personality development, the ability to adapt to stressful situations, successful socialization, and educational activities are all elements of training the future generation. Psychological and pedagogical support of students plays a significant role in these processes, as it is at the stage of secondary education that a child does not have a formed psyche, or a clear worldview and is only at the beginning of his or her personal development trajectory. The teacher plays the role of an assistant in this process. The conditions of war pose serious challenges for children in Ukraine, many of whom have already faced losses, whether material or the loss of a loved one. Schools are one of the most stable social institutions, and psychological and pedagogical support for students in war is a fundamental element of the educational process in today's realities, it is of great practical importance in working with children in Ukraine and their psychological and emotional recovery, which emphasizes the importance of studying the issue. The scientific article is an original study of the essence and significance, characteristic features, tools of psychological and pedagogical support for students developing in the context of armed conflict and suffering losses from the war in Ukraine. The methods of analysis, comparison, abstraction, and generalization were used to implement the study. The paper determines the essence of psychological and pedagogical support for students, which can be implemented by general secondary education institutions represented by teachers, psychologists, and social workers, the characteristic features of such support and its importance for children whose worldview is only being formed and is particularly vulnerable to the impact of war and the losses that accompany armed conflict. The authors studied psychological and pedagogical support in two contexts: as a process of searching for and identifying psychological problems in children who have suffered losses from the war in Ukraine, as well as a set of measures aimed at working out the child's issues, correcting his or her behavior and preventing the impact of the shock on personal growth, physical and intellectual development, communication skills, etc. Based on the study of these aspects, the authors focused on the applied role of psychological and pedagogical support at school and analyzed several practical ways to ensure psychological and pedagogical work with students who suffered losses during the war.

To identify early life factors associated with posttraumatic stress disorder (PTSD), we investigated the association between childhood trauma and mental disorders with International Classification of Diseases (ICD)-diagnosed past-year PTSD in employed military and civilian men. Data were derived from the2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (N = 1,356) and the 2007 Australian Bureau of Statistics (ABS) National Survey of Mental Health and Wellbeing Study (N = 2,120) and analyzed using logistic regression and generalized structural equation modeling. After controlling for demographics, PTSD was associated with childhood anxiety, adjusted odds ratio (AOR) = 3.94, 95% CI [2.36, 6.58]; and depression, AOR = 7.01, 95% CI [2.98, 16.49], but not alcohol use disorders, in the ADF. In civilians, PTSD was associated with childhood anxiety only, AOR = 7.06, 95% CI [3.50, 14.22]. These associations remained significant after controlling for childhood and adult trauma in both populations and service factors and deployment, combat, or adult trauma in the ADF. In both populations, PTSD was associated with more than three types of childhood trauma: AOR = 2.97, 95% CI [1.53, 5.75] for ADF and AOR = 5.92, 95% CI [3.00, 11.70] for ABS; and childhood interpersonal, but not noninterpersonal, trauma: AOR = 3.08, 95% CI [1.61, 5.90] for ADF and AOR = 6.63, 95% CI [2.74, 16.06] for ABS. The association between childhood trauma and PTSD was fully mediated by childhood disorder in the ADF only. Taking a lifetime perspective, we have identified that the risk of PTSD from childhood trauma and disorder is potentially predictable and, therefore, modifiable.

BackgroundPrimary headaches affect between 40% and 50% of people worldwide and are linked to a range of medical and mental health conditions, including post-traumatic stress disorder (PTSD). Our objective is to assess the prevalence of primary headaches in individuals with PTSD, identify the types, timing, and impact of traumatic experiences, and compare this prevalence to that of the general population.MethodsThis descriptive, retrospective observational study included 302 patients. Each participant was initially assessed using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) PTSD criteria, the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), the International Classification of Headache Disorders, 3rd edition (ICHD-3) for headache classification, and the Hospital Anxiety and Depression Scale (HADS). Both type 1 and type 2 trauma, whether occurring in childhood or adulthood, were identified, along with the nature of the trauma.ResultsThe age of the population was 42 ± 14 years, with a PCL-5 score of 47.6 ± 9.9. A total of 77% of patients were diagnosed with primary headaches, including 47% with tension-type headaches (TTH) and 30% with migraines. Chronic migraine sufferers reported significantly higher rates of childhood trauma (71%), while episodic migraineurs showed similar rates of both childhood and adult trauma. Chronic TTH patients experienced more childhood trauma (91%) compared to adulthood trauma, whereas episodic TTH patients reported a higher incidence of adulthood trauma than childhood trauma. The majority of childhood traumas were of type 2 and intrafamilial origin, with 45% of patients reporting sexual abuse, 51% physical abuse, and 4% other types of trauma. In the adulthood trauma group, 34% reported sexual abuse, 40% physical abuse, and 26% other forms of trauma, with a notably high rate of intimate partner abuse (both type 1 and type 2). We observed significantly higher rates of migraine (OR = 1.59, 95% CI: 1.23–2.05) in our cohort compared to the general population, with particularly higher prevalences in men and older patients. A significant association was found between childhood trauma and the presence of chronic headache in the overall headache cohort and in patients with TTH. However, no statistically significant association was observed among patients with migraine.ConclusionsPatients with PTSD exhibit a higher prevalence of primary headaches, likely due to childhood trauma. Headache specialists should routinely screen for trauma and offer tailored treatments to address these underlying factors.

A growing body of evidence suggests a link between early childhood trauma, post-traumatic stress disorder (PTSD) and higher risk for dementia in old age. The aim of the present study was to investigate the association between childhood trauma exposure, PTSD and neurocognitive function in a unique cohort of former indentured Swiss child laborers in their late adulthood. To the best of our knowledge this is the first study ever conducted on former indentured child laborers and the first to investigate the relationship between childhood versus adulthood trauma and cognitive function. According to PTSD symptoms and whether they experienced childhood trauma (CT) or adulthood trauma (AT), participants (n = 96) were categorized as belonging to one of four groups: CT/PTSD+, CT/PTSD-, AT/PTSD+, AT/PTSD-. Information on cognitive function was assessed using the Structured Interview for Diagnosis of Dementia of Alzheimer Type, Multi-infarct Dementia and Dementia of other Etiology according to ICD-10 and DSM-III-R, the Mini-Mental State Examination, and a vocabulary test. Depressive symptoms were investigated as a potential mediator for neurocognitive functioning. Individuals screening positively for PTSD symptoms performed worse on all cognitive tasks compared to healthy individuals, independent of whether they reported childhood or adulthood adversity. When controlling for depressive symptoms, the relationship between PTSD symptoms and poor cognitive function became stronger. Overall, results tentatively indicate that PTSD is accompanied by cognitive deficits which appear to be independent of earlier childhood adversity. Our findings suggest that cognitive deficits in old age may be partly a consequence of PTSD or at least be aggravated by it. However, several study limitations need to considered. Consideration of cognitive deficits when treating PTSD patients and victims of lifespan trauma (even without a diagnosis of a psychiatric condition) is crucial. Furthermore, early intervention may prevent long-term deficits in memory function and development of dementia in adulthood.

Childhood trauma constitutes a major risk factor for adult psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and somatic symptom disorder (SSD). One potential mechanism linking childhood trauma to adult psychopathology may be alterations in theory of mind (ToM). Given the lack of transdiagnostic studies on the association between childhood trauma and ToM, further research is needed to elucidate whether and how childhood trauma relates to ToM impairments across and within diagnostic boundaries. A cross-sectional study design was applied. A total of 137 individuals with varying levels of childhood trauma took part in this study, encompassing individuals with PTSD (n = 33), MDD (n = 33), SSD (n = 36), and healthy volunteers (HVs; n = 35). To assess ToM performance and childhood trauma, the Movie for the Assessment of Social Cognition was administered along with the Childhood Trauma Questionnaire. Only individuals with PTSD, but not individuals with MDD or SSD, showed a worse ToM performance compared to HVs. In the whole sample, childhood trauma correlated negatively with ToM performance. Exploratory group-specific analyses revealed higher levels of childhood trauma to be associated with more excessive ToM errors in individuals with SSD, and notably with an enhanced ToM performance in individuals with MDD. Our results indicate associations between childhood trauma and ToM impairments in a large, transdiagnostic sample. Provided replication in future studies, our findings suggest ToM capacities as a promising treatment target for individuals exposed to severe childhood trauma, at least or particularly with a diagnosis of PTSD. Our results suggest that individuals with a history of severe childhood trauma, at least or particularly with a clinical diagnosis of posttraumatic stress disorder, may benefit from therapeutic approaches targeting theory of mind capacities. Our findings indicate that higher levels of childhood trauma may be linked to a specific 'hypermentalizing' bias in somatic symptom disorder. Our findings further point towards an association between higher levels of childhood trauma and a heightened - rather than a diminished - sensitivity towards interpersonal cues in major depressive disorder. Provided further confirmatory evidence, our findings may support diagnosis-specific approaches in ameliorating theory of mind abilities in individuals with different mental disorders and a history of severe childhood trauma.

Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) are frequently comorbid disorders. Given evidence that childhood traumas may be associated with broader, more severe psychological sequelae than later traumas, the present study examined whether the association between alcohol and trauma symptomatology is more pronounced among individuals with earlier trauma onsets in a sample of 42 childhood and adolescent trauma survivors diagnosed with comorbid AD-PTSD. As predicted, individuals reporting childhood traumas reported greater severity of trauma and alcohol symptoms and greater alcohol craving. These results suggest that individuals with childhood trauma histories may be particularly vulnerable to relapse following AD treatment.

Trauma and posttraumatic stress disorder (PTSD) are associated with problematic parenting and incidence of trauma and PTSD in children of affected parents. In communities impacted by frequent trauma, parenting may be particularly important to children's PTSD risk. The authors examined relationships among maternal and child trauma and mental health, as well as problematic parenting. The authors recruited 112 mother-child dyads (50 girls, 62 boys; ages 8-12 years old) from a community sample of low-income, primarily African American families. They examined rates of trauma exposure and PTSD symptoms in mothers and children, the association of maternal trauma and PTSD with self-reported child abuse potential and parenting stress (i.e., parental distress, dysfunctional parent-child interactions, and perceived child difficulty), and the impact of maternal trauma, PTSD, and parenting on child trauma and PTSD. Rates of trauma and PTSD symptoms were relatively high for mothers and children and included community and family violence. Maternal trauma and PTSD predicted child abuse potential, but only maternal PTSD predicted parental distress. Neither maternal trauma nor PTSD predicted parent-reported dysfunctional parent-child interactions or child difficulty. Maternal child abuse potential and child self-reported trauma, but not maternal trauma or PTSD, significantly predicted child self-reported PTSD. Parenting stress was not associated with child PTSD. Trauma and PTSD in parents may impact parental distress and child abuse potential, potentially increasing children's risk for not only the experience of child abuse, but also PTSD. Child and family interventions should consider child and parental trauma and PTSD as important factors to address. (PsycINFO Database Record

This article argues that child protection rhetoric rarely applies to all children and that it, in fact, often contains decisions over whose lives are worthy of protection, and whose are not. In Russia, “traditional (family) values” have effectively become state policy, the 2013 federal law “for the Purpose of Protecting Children from Information Advocating for a Denial of Traditional Family Values” being the most prominent example of this. The fixation of such “traditional values” discourses on protecting children from “early sexualization” by barring them from access to LGBTQ-inclusive education and care demonstrates that the child on whose behalf this protection is demanded is deemed to be straight, while further examples of child protection discourses also show that innocence is often viewed as the exlusive property of white, middle-class children. Responding to the recent escalation of Russia’s war on Ukraine, this text discusses how the trauma, displacement and death of children in Ukraine reveals the biopolitical core of traditional values discourses.

Trauma exposure and PTSD symptoms associate with violence in inner city civilians

Background: Much of the research on anxiety disorders has focused on associated risk factors with less attention paid to factors such as resilience that may mitigate risk or offer protection in the face of psychopathology.Objective: This study sought to compare resilience in individuals with posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) relative to age-, gender- and education- matched individuals with no psychiatric disorder. We further assessed the correlation of resilience scores with childhood trauma severity and type.Method: The sample comprised of 93 participants, 40 with SAD with childhood trauma), 22 with PTSD with childhood trauma, and 31 with no psychiatric disorder (i.e., healthy matched controls). Participants were administered the Mini-International Neuropsychiatric Interview (MINI), Liebowitz Social Anxiety Scale (LSAS), Clinician-Administered PTSD Scale (CAPS), Childhood Trauma Questionnaire—Short Form (CTQ-SF), and the Connor-Davidson Resilience Scale (CD-RISC). The mean age of participants was 34 years (SD = 11). 52 Participants were female (55.9%) and 54 Caucasian (58.1%). Analysis of variance was used to assess for significant group differences in resilience scores. Non-parametric correlation analyses were conducted for resilience and different types of childhood trauma.Results: There were significant differences in resilience between the SAD and PTSD groups with childhood trauma, and controls. Both disorder groups had significantly lower levels of resilience than healthy controls. No significant correlation was found between total resilience scores and childhood trauma scores in the childhood trauma (SAD and PTSD) groups. However, in the combined dataset (SAD, PTSD, healthy controls), significant negative correlations were found between resilience scores and emotional abuse, emotional neglect, and total childhood trauma scores.Conclusions: Patients who have PTSD and SAD with childhood trauma appear to be significantly less resilient than those with no disorder. Assessing and addressing resilience in these disorders, particularly when childhood trauma is present, may facilitate long-term recovery and warrants further investigation.

Risk for posttraumatic stress disorder (PTSD) is thought to be mediated by gene × environment (G × E) interactions that affect core cognitive processes such as fear learning. The catechol-O-methyltransferase (COMT) val158met polymorphism has been associated with risk for PTSD and impaired fear inhibition. We used a large, relatively homogenous population to (1) replicate previous findings of poor fear inhibition in COMT Met/Met carriers with PTSD; (2) determine if COMT association with fear inhibition is moderated by childhood trauma (CT), an environmental risk factor for PTSD; and (3) determine if COMT is associated with altered fear processes after recent exposure to combat trauma. Male Marines and Navy Corpsmen of European-American ancestry were assessed prior to (n = 714) and 4-6 months after deployment to Afghanistan (n = 452). Acquisition and extinction of fear-potentiated startle, childhood and combat trauma history, and PTSD diagnosis were assessed at both time points. Before deployment, Met/Met genotype was associated with fear inhibition deficits in participants with current PTSD; however, this association was dependent on CT exposure. After deployment, combat trauma was associated with a modest reduction in fear extinction in Met/Met compared with Val/Val carriers. There were no associations of COMT genotype with fear extinction within healthy and non-traumatized individuals. These findings support the hypothesis that G × E interactions underlie associations of COMT val158met with fear inhibition deficits. These studies confirm that Met/Met carriers with PTSD have poor fear inhibition, and support further research in understanding how this polymorphism might impact response to extinction-based therapies.

Rates of posttraumatic stress are elevated in individuals who have experienced childhood and/or cumulative trauma, and trauma appraisals have been suggested as a possible mediator of this effect. This study tested the proposed mediating role of trauma appraisals between both childhood and cumulative trauma, and two markers of trauma-related distress; posttraumatic stress and depression. Mediation models were developed and tested with data collected from a sample of trauma-exposed, treatment receiving adults (N = 106). Trauma appraisals fully mediated relationships between childhood trauma and PTSD/depression. Appraisals also mediated the relationships between cumulative trauma and depression. When appraisal subscales were simultaneously entered, alienation appraisals were the only significant mediator of these relationships. The study found support for the proposed mediating role of trauma appraisals between different forms of trauma and trauma related distress. Alienation appraisals were particularly emphasised.